Active NPI
Mark Garden, LMHC
- Mental Health Counselor
- Bettendorf, IA
National Provider Identifier
1306402854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 079924
- Practice address
- 2435 Kimberly Rd Ste 96S
Bettendorf, IA 52722-3505 - Phone
- (563) 940-2321
- NPI assigned
- May 9, 2019
- Last updated
- May 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 079924 | IA | Primary |
Addresses
Primary practice location
2435 Kimberly Rd Ste 96S
Bettendorf, IA 52722-3505
Mailing address
405 S 9TH Ave
Eldridge, IA 52748-2022
Phone (563) 940-2321
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mhgarden@mchsi.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 079924 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557360000000",
"number": "1306402854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 S 9TH AVE",
"city": "ELDRIDGE",
"state": "IA",
"postal_code": "527482022",
"telephone_number": "563-940-2321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2435 KIMBERLY RD STE 96S",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527223505",
"telephone_number": "563-940-2321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDEN",
"first_name": "MARK",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-09",
"last_updated": "2019-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "079924",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mhgarden@mchsi.com",
"affiliation": "N",
"address_1": "2435 Kimberly Rd Ste 96S",
"city": "Bettendorf",
"state": "IA",
"country_code": "US",
"postal_code": "527223505",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bettendorf, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.